meningoencephalitis (TM) and human immunodeficiency virus (HIV) co-infection in the intensive phase of treatment.METHODS: Fifty-four patients with TB/TM and HIV co-infection were enrolled for this study. Group 1 comprised of 23 patients treated with E and H intravenously, while rifampicin and pyrazinamide were prescribed orally. Group 2 consisted of 31 patients treated with the first-line anti-TB drugs orally. The concentrations of H and E in blood serum were detected using a chromatographic method.RESULTS: A significant improvement in the clinical symptoms and X-ray signs in patients treated intravenously with H and E was observed and compared to group 2. The sputum Mycobacterium tuberculosis positivity was observed during the second month of the treatment in 25.0% of patients from group 1 and 76.1% of the patients from the control group (p=0.003). In addition, nine patients (39.1%) died up to 6 months when H and E were prescribed intravenously compared with 22 (70.9%) in group 2 (p=0.023).CONCLUSION: In TB/TM with HIV, the intravenous H and E treatment was more effective than oral H and E treatment at 2 months of intensive treatment in sputum conversion as well as in clinical improvement, accompanied by significantly higher mean serum concentrations. In addition, the mortality rate was lower in intravenous H and E treatment compared to oral treatment.]]>
Coinfection ; Ethambutol ; HIV Infections ; HIV ; Humans ; Isoniazid ; Meningoencephalitis ; Methods ; Mortality ; Mycobacterium tuberculosis ; Pyrazinamide ; Rifampin ; Serum ; Sputum ; Tuberculosis ; Tuberculosis, Meningeal ; Tuberculosis, Pulmonary

Ramsay Hunt syndrome with the complication of encephalitis or meningoencephalitis is rarely reported and uncommon in immunocompetent patients. The radiological manifestations of such cases usually involve the cerebellum and brainstem or exhibit the absence of any abnormality. We report a case of a 78-year-old immunocompetent man hospitalized with Ramsay Hunt syndrome, who later developed meningoencephalitis. The cerebrospinal fluid-study excluded other causes of meningoencephalitis, and the clinical diagnosis indicated varicella zoster virus meningoencephalitis. Magnetic resonance imaging revealed increased signal intensities in the bilateral temporal lobe, midbrain, and pons on T2-weighted imaging, and T2 fluid attenuated inversion recovery and contralateral asymmetric pachymeningeal enhancement. Contrast-enhanced T1-weighted imaging revealed ipsilateral facial nerve enhancement.
Aged ; Brain Stem ; Cerebellum ; Diagnosis ; Encephalitis ; Facial Nerve ; Herpes Zoster Oticus ; Herpesvirus 3, Human ; Humans ; Magnetic Resonance Imaging ; Meningoencephalitis ; Mesencephalon ; Pons ; Temporal Lobe

A 10-year-old male spotted seal presented with loss of appetite and decreased activity. Grossly, the internal organs revealed several filarial nematodes in the right ventricle of the heart and the pulmonary vessels. Histopathological examination of the brain revealed moderate nonsuppurative meningoencephalitis with glial nodules and neuronophagia. Japanese encephalitis virus (JEV) of genotype I was isolated from the brain. All nematodes were identified as Dirofilaria immitis. This is the first clinical case of co-infection with D. immitis and JEV in a seal, suggesting that the seal, may be a dead-end host, like the human and horse, for JEV.
Appetite ; Asian Continental Ancestry Group ; Brain ; Child ; Coinfection ; Dirofilaria immitis ; Dirofilaria ; Encephalitis Virus, Japanese ; Encephalitis, Japanese ; Genotype ; Heart ; Heart Ventricles ; Horses ; Humans ; Male ; Meningoencephalitis ; Republic of Korea

A 6-year-old intact male Maltese dog presented with a history of blindness and ataxia. Neuro-ophthalmic examination revealed dilated pupils with absent pupillary light reflexes and menace response in both eyes. Mild peripapillary edema was noted in the fundus of the right eye. After magnetic resonance imaging, the dog was provisionally diagnosed with meningoencephalitis of unknown etiology. Follow-up funduscopy was performed to monitor the condition of the optic discs for three years. Despite of the treatment with prednisolone, the optic nerve progressed to atrophy and the dog couldn't restore vision.
Animals ; Ataxia ; Atrophy ; Blindness ; Child ; Dogs ; Edema ; Follow-Up Studies ; Humans ; Magnetic Resonance Imaging ; Male ; Meningoencephalitis ; Optic Nerve ; Optic Neuritis ; Prednisolone ; Pupil ; Reflex

Primary amebic encephalitis (PAM) is a devastating central nervous system infection caused by Naegleria fowleri, a free-living amoeba, which can survive in soil and warm fresh water. Here, a 43-year-old healthy male was exposed to warm freshwater 5 days before the symptom onset. He rapidly developed severe cerebral edema before the diagnosis of PAM and was treated with intravenous conventional amphotericin B while died of terminal cerebral hernia finally. Comparing the patients with PAM who has similar clinical symptoms to those with other common types of meningoencephalitis, this infection is probably curable if treated early and aggressively. PAM should be considered in the differential diagnosis of purulent meningoencephalitis, especially in patients with recent freshwater-related activities during the hot season.
Adult ; Amoeba ; Amphotericin B ; Brain Edema ; Central Nervous System Infections ; Central Nervous System Protozoal Infections ; Diagnosis ; Diagnosis, Differential ; Encephalitis ; Encephalocele ; Fresh Water ; Humans ; Male ; Meningoencephalitis ; Naegleria fowleri ; Seasons ; Soil

No abstract available.
Choroid ; Meningoencephalitis

No abstract available.
Edema ; Humans ; Meningoencephalitis

Eight rabbits exhibited head tilt and subsequently died. At necropsy, three rabbits had crusty deposits in ears and four had reddish lungs. The main histopathological features were severe diffuse suppurative meningoencephalitis (75.0% of rabbits), fibrinopurulent pneumonia (37.5%), and otitis externa (37.5%). Pasteurella multocida (P. multocida) was isolated from brains, ears, and lungs. The capsular serogroups of the isolates were untypable. Based on histopathological features and bacterial analysis results, the rabbits were diagnosed as P. multocida infection. P. multocida infections might result in considerable economic loss in commercial rabbit production facilities in Korea.
Brain ; Ear ; Head ; Korea ; Lung ; Meningoencephalitis ; Otitis Externa ; Pasteurella Infections ; Pasteurella multocida ; Pasteurella ; Pneumonia ; Rabbits ; Serogroup

Meningitis is a common central nervous system (CNS) complication of the mumps, a viral infection, but encephalitis and meningoencephalitis are less common in mumps. We describe magnetic resonance imaging findings of acute mumps meningoencephalitis in a 32-year-old male who showed bilateral hippocampal lesions without preceding parotitis. Although it is rare, hippocampal involvement should be considered a CNS complication of mumps infection.
Adult ; Brain ; Central Nervous System ; Encephalitis ; Hippocampus ; Humans ; Magnetic Resonance Imaging* ; Male ; Meningitis ; Meningoencephalitis* ; Mumps* ; Parotitis*

BACKGROUND: Herpes zoster meningitis and meningoencephalitis, rare complications of herpes zoster, may follow the onset of rash, precede it, or even occur without rash. There have been few studies describing the order of occurrence of neurological symptoms and zoster. OBJECTIVE: We compared the clinical and laboratory features, treatments, and progress of the conditions among patients with herpes zoster meningitis and meningoencephalitis according to the timing of zoster onset in relation to neurological symptoms and also according to the immune status. METHODS: We performed a retrospective review of 21 patients with meningitis and 3 patients with meningoencephalitis who showed the characteristic rash of herpes zoster at National Health Insurance Service Ilsan Hospital between March 2000 and June 2015. RESULTS: The 11 patients in whom zoster preceded neurological symptoms had a shorter duration of neurological symptoms (median 3 days; range 1~10) than did the 13 patients who experienced neurological symptoms first (median 10 days; range 4~27) (p<0.05). The intervals between the onset of neurological symptoms and a) presentation to the hospital, b) cerebrospinal fluid tests, and c) intravenous acyclovir treatment were all shorter in the patients with zoster preceding neurological symptoms (p<0.05). No significant differences in age or immune status were observed between the two groups. In the 9 immunocompromised patients, higher incidence of meningoencephalitis and neurologic complications was noted in comparison to the 15 immunocompetent patients (p<0.05). CONCLUSION: Antecedent zoster rash in varicella zoster virus-induced meningitis and meningoencephalitis appears to lead to more rapid initiation of diagnostic tests and antiviral treatment. The possibility of central nervous system complications should not be overlooked even in patients with herpes zoster.
Acyclovir ; Central Nervous System ; Cerebrospinal Fluid ; Chickenpox* ; Diagnostic Tests, Routine ; Exanthema ; Herpes Zoster ; Herpesvirus 3, Human* ; Humans ; Immunocompetence ; Immunocompromised Host ; Incidence ; Meningitis* ; Meningoencephalitis* ; National Health Programs ; Retrospective Studies